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      저자 : Jack M. Qian (검색결과 1 건)
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        Impact of vaginal cylinder diameter on outcomes following brachytherapy for early stage endometrial cancer

        Jack M. Qian,John M. Stahl,Melissa R. Young,Elena Ratner,Shari Damast 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.6

        Objective: To examine the outcomes (tolerability, toxicity, and recurrence) of vaginalbrachytherapy (VBT) among endometrial cancer (EC) patients treated with small cylinder size. Methods: Patients with EC who received adjuvant VBT between September 2011 andDecember 2015 were reviewed. Patients were fitted with the largest vaginal cylinder theycould comfortably accommodate, from 2.0–3.0 cm diameter. Small cylinders were defined assize 2.3 cm or less. Patient, tumor, or treatment characteristics were correlated with need forsmall cylinders. Treatment tolerability, measures of gastrointestinal (GI), genitourinary (GU),and vaginal toxicity, and rates of recurrence were analyzed. Results: Three hundred four patients were included. Small cylinders were used in 51 patients(17%). Normal body mass index (BMI; p<0.001), nulligravidity (p<0.001), and shorter vaginallength (p<0.001) were associated with small cylinder size. There was no acute or late grade 3toxicity. Rates of acute (grade 1–2) GI, GU, or vaginal symptoms were low (10%, 11%, and 19%,respectively). Small cylinder size was associated with increased likelihood of reporting acuteGI (p<0.05) but not GU or vaginal symptoms. Small cylinder size was associated with higherrisk of grade 1–2 vaginal stenosis (odds ratio [OR]=4.7; 95% confidence interval [CI]=1.5–14.7;p=0.007). There was no association between cylinder size and recurrence rate (p=0.55). Conclusion: VBT is generally very well tolerated, however, patients fitted with smallercylinders (commonly nulligravid and low BMI) may have increased side effects. Further studyto improve the dosimetry of VBT for patients requiring small cylinders may be worthwhile.

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